{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:07:24Z","timestamp":1788894444466,"version":"build-2803163510"},"reference-count":85,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":125,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R21DA053164"],"award-info":[{"award-number":["R21DA053164"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH102171"],"award-info":[{"award-number":["R01MH102171"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH126762-04S1"],"award-info":[{"award-number":["R01MH126762-04S1"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute of Drug Abuse","doi-asserted-by":"crossref","award":["R25DA050724"],"award-info":[{"award-number":["R25DA050724"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Young Black sexual minority men living with HIV (YBSMM+) in the US South face a confluence of structural and psychosocial barriers that impact antiretroviral therapy (ART) adherence. Internalized heterosexism and hazardous drinking have emerged as significant yet understudied factors influencing adherence self-efficacy, a known determinant of sustained ART adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study examined the relationships among internalized heterosexism, adherence self-efficacy, and ART adherence in a sample of YBSMM+, with a particular focus on the moderating role of hazardous drinking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Utilizing cross-sectional survey data from a community-based sample of YBSMM+ in the US South, we conducted moderated mediation analyses to assess the direct and indirect effects of internalized heterosexism on ART adherence via adherence self-efficacy, as well as whether hazardous drinking moderates the direct effect of internalized heterosexism on adherence self-efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings indicated that higher levels of internalized heterosexism were associated with lower adherence self-efficacy, which in turn predicted lower ART adherence. Adherence self-efficacy significantly mediated the relationship between internalized heterosexism and ART adherence, replicating prior research. Moreover, participants who reported hazardous drinking evidenced a stronger inverse association between internalized heterosexism and adherence self-efficacy than those who did not report hazardous drinking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results underscore the complex interplay among internalized heterosexism, adherence self-efficacy, and hazardous drinking in shaping ART adherence among YBSMM+. Interventions targeting adherence self-efficacy and addressing hazardous drinking, while also directly addressing internalized stigma, may help buffer the harmful effects of these factors and support improved HIV health outcomes in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/abm\/kaag019","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T11:33:57Z","timestamp":1776166437000},"source":"Crossref","is-referenced-by-count":0,"title":["Efficacy on the rocks: how hazardous drinking contextualizes the path from internalized heterosexism to antiretroviral adherence via adherence self-efficacy"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6061-6400","authenticated-orcid":false,"given":"Stephen D","family":"Ramos","sequence":"first","affiliation":[{"name":"Department of Psychology, California State University, 5500 University Parkway, San Bernardino, California 92407, United 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